Abortion Access in Latin Migration Routes

by Ipas
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Abortion Access in Latin Migration Routes
Abortion Access in Latin Migration Routes
Abortion Access in Latin Migration Routes
Abortion Access in Latin Migration Routes
Abortion Access in Latin Migration Routes
Abortion Access in Latin Migration Routes
Abortion Access in Latin Migration Routes
Abortion Access in Latin Migration Routes
Abortion Access in Latin Migration Routes
Abortion Access in Latin Migration Routes
Abortion Access in Latin Migration Routes
Abortion Access in Latin Migration Routes
Abortion Access in Latin Migration Routes
Abortion Access in Latin Migration Routes
Abortion Access in Latin Migration Routes

At Ipas Central America and Mexico (CAM) we work to ensure that women and all people who can get pregnant have the correct information, feel supported in their decisions, and have the confidence to access safe abortion and contraceptive services when they need them. Our approach starts by centering on the individual, with the goal of achieving a better understanding of the complexity of the environment in which people make abortion decisions—or, as we call it, the abortion ecosystem. We are working toward the sustainability of the abortion ecosystem, a “dynamic condition in which resilient local stakeholders and systems are actively accountable and committed to abortion rights and responsive to everyone’s abortion needs.”

During the COVID-19 pandemic, the health, safety, and well-being of many people were threatened by the effects of the public health and economic crises that disproportionately affect women, especially those from historically underserved groups. Ipas CAM strengthened our efforts to respond directly to women’s needs during the pandemic, defend human rights, and support access to safe reproductive health care in a timely manner. Despite a significant reduction in sexual and reproductive health services reported in 2020, Ipas-supported health facilities provided 25,724 abortions and 46,837 contraceptive care methods. The abortion accompaniment networks we work with supported 498 women to self-manage their abortions with pills. To achieve these results, we targeted our actions using the eight components of the sustainable abortion ecosystem so that all people can make informed decisions and access abortion care that meets their needs. Some of our key results are as follows:

  • We shared information with more than 40 million people on Facebook and 59,000 people on Instagram.
  • Our posts on Twitter received almost 1,700,000 impressions.
  • We increased online support to women seeking abortion information and accompaniment, from 129 in 2019 to 1,489 in 2020, and we responded to 402 women seeking information on sexual health and violence. We launched a new video on safe abortion with pills with Spanish and English voiceover and subtitles that describes how to terminate a pregnancy using misoprostol.
  • The YouTube video surpassed one million views organically and received over 9,500 comments in just seven months. We shared the video with 9,968 people during a webinar with safe2choose, Hablemos de Sexo y Amor, and Hesperian Health Guides. Our participation in 141 media interviews was shared with 1,455,911 people.
  • We trained and supported 46 members of nine safe abortion accompaniment networks from El Salvador, Guatemala, Honduras, Mexico, and Nicaragua.
  • We provided grants and technical assistance to 48 grassroots organizations with 9,269 members in El Salvador, Guatemala, Honduras, Mexico, and Nicaragua. Through media outreach activities, organizations share information on sexual and reproductive health and rights with 1,088,228 people. Another 14,658 people were reached through workshops, meetings, and public events.
  • Ipas CAM provided support to 10 grantees to develop 18 educational materials for community dissemination. To respond to COVID-19, we helped design and distribute face masks, bags, t-shirts, cups, and bottles of hand sanitizer with messages on sexual and reproductive rights.

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Dr. Ortiz, Inter-American Human Rights Court
Dr. Ortiz, Inter-American Human Rights Court

I want to start this report by thanking you for your commitment and support to reproductive rights in Central America and Mexico. At Ipas CAM, we are grateful for you and know that we can count on you to advance our agenda in the region. This year has been extremely challenging but also exciting and your support through GlobalGiving has helped us to keep the hard work going even in these times of uncertainty. Below, you will find some updates from our work.

Mexican Supreme Court ruled in favor of decriminalizing abortion and more states passed legislation to make abortion legal and safe.

The recent months have been extremely intense on the sexual and reproductive rights agenda in Mexico. The Mexican Supreme Court ruled anti-constitutional the criminalization of women, medical staff, and anyone who supports women getting a voluntary abortion, opening the way for all Mexican states to follow the steps of Mexico City, Oaxaca, and Hidalgo. In the past six months the states of Veracruz, Baja California and Colima had decriminalize abortion and more than ten states Congress are analyzing bills on this issue.

On September 7, the Mexican Supreme Court unanimously ruled that it is unconstitutional to criminalize abortion. The Court declared the invalidity of Article 196 of the Penal Code of Coahuila, which established a prison sentence for a woman who voluntarily performs an abortion or anyone who helps her have an abortion. From now on, when deciding future cases, Mexican judges will have to consider as unconstitutional the penal norms of the states that criminalize abortion in an absolute manner.

During the same week, the Court invalidated an article of the Sinaloa State Constitution, which established the protection of the right to life from the moment of conception, declaring that the State Congress’s do not have the power to create legal personhood.

Finally, in the same month, the Court also declared invalid the conscientious objection article of the General Health Law and asked Congress to review it as it was a "blank check" for health care providers to deny abortion services. Congress must now review the article to limit conscientious objection and ensure that it is not a barrier to access to safe and legal abortion services.

The decisions of the Court sent a clear message to state legislators on the importance of decriminalizing abortion. On December 1st the congress of Colima approved reforms to the Penal Code of the State, which decriminalize voluntary abortion in the first twelve weeks of gestation and expand the circumstances under which abortion is legal with two exceptions, on top of the ones that already exist in the State:

  • When the authority had previously denied the legal abortion service within the first twelve weeks of gestation.
  • When during the provision of the service, the medical or nursing personnel had omitted to correctly and timely inform the pregnant woman of her right to terminate her pregnancy legally and safely within the first twelve weeks of gestation.

The reforms also reduce the penalties for pregnant women who consent to abortion after twelve weeks of gestation and increase the penalty for the crime of forced abortion.

In addition, amendments to the State Health Law were approved to include a chapter on the provision of pregnancy termination services, to consider sexual and reproductive health and family planning as a priority, and to ensure the provision of abortion services in the event of conscientious objection by medical personnel. Colima thus becomes the sixth state to recognize women's autonomy to decide whether to terminate a pregnancy in the first twelve weeks of gestation.

Inter-American Court rules in favor of Manuela a woman who was unfairly incarcerated under the El Salvador abortion law

The Inter-American Court has ruled in the case of Manuela and family members v. El Salvador for criminalizing women's access to emergency obstetric services and forcing health professionals to denounce women who seek care.

In the judgment, the Court recognizes that "...the ambiguity of medical professional secrecy [in Salvadoran law] ... implies that health personnel, to avoid being sanctioned, denounce women suspected of having committed the crime of abortion." At the same time, it recognizes that the confidentiality of medical records and the exceptionality of their disclosure are not sufficiently regulated in the country. It, therefore, recommends that the state adopt, within no more than two years from the notification of the judgment, clear regulations on the scope of medical professional secrecy, the protection of medical records and their exceptions to disclosure, following the standards developed in the decision, establishing that:

  • Medical and health personnel do not have an obligation to denounce women who have received medical care for possible abortions.
  • Health personnel must maintain professional secrecy in these cases in the face of questioning by the authorities.
  • Failure to report by medical or health personnel should not result in administrative, criminal, or any other type of sanction.

On the other hand, the Court recognized that Manuela suffered an obstetric emergency caused by pre-eclampsia due to health conditions before pregnancy that the health system in El Salvador failed to detect in time.

As a result of the actions of medical personnel, authorities, and the state in general, the Court recognizes that Manuela's human rights were violated, especially her right to life, to health, to judicial protection and guarantees, and to be free from discrimination and gender-based violence, among others.

Ipas Central America and Mexico collaborated with petitioning organizations by participating as an expert witness during the trial. During the hearings, Guillermo Ortiz, Ipas Global Medical Advisor, stated that based on scientific evidence, Manuela suffered an obstetric emergency due to her deteriorated state of health and the lack of timely medical attention. He also recalled as standard practice the denunciation by health personnel of any woman who comes to seek obstetric care as a possible commission of a crime, under threat of severe sanctions if she does not do so.

We applaud the work of the Center for Reproductive Rights and the Feminist Collective for Local Development, which with the support of the Citizens' Group for the Decriminalization of Abortion in El Salvador, have achieved #JusticeForManuela and her family. This case will be paramount to the defense and promotion of reproductive rights in the region.

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First, thank you for your commitment to reproductive rights and access to abortion and contraceptive care in Central America and Mexico. We are grateful to have you on our team as we work to ensure all women and girls in the region can choose their own futures. When the pandemic hit in early 2020, Ipas CAM pivoted quickly to adapt to a new and changing reality, and your support through GlobalGiving has helped us adapt and innovate widely across our programs. Below, you will find some programmatic updates from the Central America and Mexico programs, and I hope you will find the progress encouraging.

Reaching Women

During the pandemic, we realized that women and girls in Latin America were looking for abortion information online, especially information on self-managed abortion with pills (what Ipas and other organizations, like the World health Organization, refer to as abortion self-care). Our review of existing sources revealed that many existing resources are text-based, contextually and/or linguistically inappropriate, and use language is less accessible to lower literacy populations. To address this, Ipas CAM created two online videos for YouTube that discuss abortion self-care and how to safely use this option for ending a pregnancy. One of these most popular YouTube videos has over 2.1 million views and counting.

Ipas CAM has also developed an abortion information chatbot for use by women and other people seeking abortion information in Central America and Mexico. To our knowledge, it represents the first-ever Spanish-language computer program in the region designed to simulate a text chat between a trained health provider and a person seeking information on safe abortion options, including the use of pills for self-managed abortion. When it comes to reproductive health information, many women may prefer to interact with chatbots instead of a person, as they feel less fear of stigma, judgement, and criminalization when seeking out information. During the pandemic, safety and comfort were added to this list, as women could access reliable information from the safety of their own homes. We are excited to see how this chatbot evolves!

Legal Abortion in Oaxaca and Beyond

To accelerate the implementation of legal abortion in Oaxaca, Mexico, which was legalized up to 12 weeks of pregnancy in 2019, we established a partnership with the National Center for Gender Equity and Reproductive Health to develop an abortion care protocol for health providers, resolve remaining legal questions and hesitation among health authorities, and develop a website aimed at informing women and other people who can become pregnant in the region of abortion legalization and how to access this right. We expect that the website will increase knowledge of the new law and put public pressure for access to care in public sector health facilities.

On June 30, 2021 the Mexican state of Hidalgo made history by being the third state in the country to legalize abortion up to 12 weeks of pregnancy. Hidalgo joins the states of Oaxaca and Mexico City in changing its laws to guarantee the reproductive rights of women. Prior to this historic law change, abortion was only legal in very limited cases such as rape, fetal anomaly, and if a women’s health or life were in danger. Ipas CAM will support health authorities and our partners in civil society to ensure that the laws are acted upon to make abortion accessible for all who need it.

Resisting Opposition

Ipas conducts opposition monitoring and response and works through coalitions to address setbacks and threats to sexual and reproductive health and rights. With local partners like pro-choice medical associations and civil society organizations, we share medical arguments in favor of abortion access. We have also been promoting government compliance and transparency with international treaties and human rights conventions to respect women’s rights and gender equality. To support these efforts, we submitted shadow letters to human rights bodies highlighting the barriers to reproductive care and violations to the rights of women and girls in places like Guatemala and El Salvador. This is critical in these countries, as abortion is criminalized in nearly all circumstances in Guatemala and completely criminalized in El Salvador, where women suspecting of seeking an abortion (including women who likely experienced a miscarriage) have been sentenced for up to 50 years in prison. Ipas is also working with diverse partners to push for the release of these women. In June, 2021, Ipas and our partners helped to secure the release from prison of Sara, a woman unjustly imprisoned for abortion in El Salvador.

Thank you!

Access to abortion and contraceptive care puts people in control of their reproductive health. Your contributions to Ipas CAM through GlobalGiving give women and girls everywhere the opportunity to determine when to have a family, and in turn give them control over their own futures.

The pandemic has changed us all, both personally and in the ways we work to ensure reproductive justice. Despite the challenges, Ipas CAM is inspired and hopeful for the future of reproductive rights and health in Central America and Mexico, and the world. Thank you for your support!

Disseminating Research on Abortion Providers
Disseminating Research on Abortion Providers
Strengthening reproductive health providers in CAM
Strengthening reproductive health providers in CAM
Supporting youth advocates for reproductive rights
Supporting youth advocates for reproductive rights
Supporting regional dialogue on safe abortion
Supporting regional dialogue on safe abortion

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Ipas

Location: Chapel Hill, NC - USA
Website:
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Twitter: @IpasOrg
Project Leader:
Daniela Perdomo
Chapel Hill, NC United States
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